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2 edition of Reducing the risk of adverse outcome for nulliparous women using epidural analgesia in labour found in the catalog.

Reducing the risk of adverse outcome for nulliparous women using epidural analgesia in labour

Susan Mary Downe

Reducing the risk of adverse outcome for nulliparous women using epidural analgesia in labour

a randomised clinical trial and longitudinal follow-up survey....

by Susan Mary Downe

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  • 16 Currently reading

Published by University of Derby] in [Derby .
Written in English


Edition Notes

Thesis (Ph. D.) - University of Derby, 1999.

ContributionsUniversity of Derby. School of Health and Community Studies.
ID Numbers
Open LibraryOL18188940M

reasons, data on women’s perception of pain relief in labour could only be included from one study which found epidural analgesia to offer better pain relief than non-epidural analgesia (weighted mean difference (WMD) , 95% con dence interval (CI) included disparate regimens for epidural analgesia and women of mixed parity.6–8 We focused on epidural infusions containing low concentra-tions of local anaesthetic as these are associated with a lower risk of operative delivery.9 To overcome the confounding effect of parity,we selected nulliparous women,who have a higher risk of dystocia.

Background: Epidural analgesia is an effective and popular way to relieve labour pain but it may interfere with normal mechanism of labour. The objective of this study was to evaluate the outcome of labour in women with effective epidural analgesia in terms of duration of labour, mode of delivery and neonatal outcome. Introduction. Epidural analgesia produces better pain relief and more maternal satisfaction than other methods of analgesia in labour 1, but its possible adverse effects have been the focus of much attention in recent perceived complications stemmed from the fact that, appropriately, it was used more in induced and high risk than in normal spontaneous labours.

OBJECTIVE To identify risk factors for difficult delivery among nulliparas in the second stage of labor with continuous epidural analgesia, and to develop a multivariable model that is predictive of difficult delivery.. METHODS The database is derived from a multicenter randomized trial of delayed pushing for nulliparous women under continuous infusion epidural. An epidural gives inadequate pain relief for 10 to 15 percent of women,55 and the epidural catheter needs to be reinserted in about 5 percent For around 1 percent of women, the epidural needle punctures the dura (dural tap); this usually causes a severe headache that can last up to six weeks, but can usually be treated by an injection into.


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Reducing the risk of adverse outcome for nulliparous women using epidural analgesia in labour by Susan Mary Downe Download PDF EPUB FB2

Introduction. Of all labour analgesia techniques, epidural analgesia is the most effective and has become the ‘gold standard’ for obstetric care. 1 Walking is commonly thought to contribute to the establishment and progression of active labour. 2 Many women want to be more involved in decision-making during childbirth, especially in relation to walking during the first stage of labour.

3 Cited by: In our population of low-risk nulliparous women, elevated intrapartum maternal temperature (>°F) among women receiving epidural analgesia was associated with a higher risk of adverse neonatal outcomes such as hypotonia, the need for assisted ventilation, low 1- and 5-minute Apgar scores, and early-onset neonatal by: Aims: This study aimed to evaluate the effect of ropivacaine epidural analgesia on duration and outcome of labour in nulliparous parturients of India with parturient not receiving any analgesia.

Settings and Design: One hundred and twenty nulliparous parturient in established labour at full term with a singleton vertex presentation were assigned to the by: 9.

Objective. The present study was designed to investigate the influence of epidural analgesia on labor progress and outcome in nulliparous s. A population-based study comparing women with and without epidural analgesia was conducted.

Deliveries occurred during – at the Soroka University Medical Center. A multivariable logistic regression model with backward elimination Cited by:   A stepwise logistic regression analysis revealed that epidural analgesia independently affected the rate of non-spontaneous delivery and the duration of the second stage of labor in nulliparous and multiparous women (Table 3, Table 4).Other factors affecting the rate of non-spontaneous delivery and the duration of the second stage of labor are also presented in these by:   Epidural block.

For women in the United States, this is the most commonly used form of pain relief during labor. It combines analgesic and anesthetic. Thorp JA et al: Effect of epidural analgesia on nulliparous labour- A Randomized Controlled prospective trial.

American journal of obstetrics and gynaecology: (4) oct 8. Chestnut DH et al: Does early administration of epidural analgesia affect obstetric outcome in nulliparous women who are in spontaneous labour. Some women expressed an a priori desire for an epidural analgesia to help with a pain-free labour, to alleviate a fear of pain and/ or to remain in control during labour (moderate confidence in the evidence), while others requested an epidural as a last resort, when the level of pain and/or sense of control over the labour was overwhelming and.

Using Epidural Anesthesia During Labor: Benefits and Risks. Epidural anesthesia is the most popular method of pain relief during labor. Women request an epidural by name more than any other method of pain relief. More than 50% of women giving birth at hospitals use epidural anesthesia.

Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour.

However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last. The use of epidural analgesia does appear to have an effect on the instrumental delivery rate.

A meta-analysis of RCTs comparing epidural with non-epidural analgesia during labour found that instrumental vaginal deliveries were more common in those receiving epidural analgesia, with an odds ratio of (95% CI –).

Discontinuation of epidural analgesia late in labour for reducing the adverse delivery outcomes associated with epidural analgesia Cochrane Database Syst Rev.

;(4):CD ;(4):CD 7. Introduction. Epidural analgesia (EA) is the most effective treatment for pain control during labour and delivery. 1, 2 The effect of regional analgesia on progress of labour and mode of delivery has often been debated.

Results of randomised controlled trials (RCTs) and systematic reviews published between and did not demonstrate any difference in the rate of caesarean. Methods: We conducted a double-blind, randomized, placebo-controlled trial involving nulliparous women with term cephalic singleton pregnancies who requested epidural analgesia.

All women. Abstract: Background: Although epidural analgesia is widespread and very effective for alleviating labor pain, its use is still controversial, as the literature is inconsistent about the risk of adverse birth outcome after administration of epidural analgesia.

The aim of this study was to explore associations between epidural analgesia and mode. In healthy women with effective epidural analgesia, passive descent was a safe and effective method of increasing spontaneous vaginal births, decreasing instrumental deliveries, and reducing time spent pushing during second-stage labour.

For technical reasons, data on women's perception of pain relief in labour could only be included from one study which found epidural analgesia to offer better pain relief than non-epidural analgesia (weighted mean difference (WMD)95% confidence interval (CI) to1 trial, women).

Epidural analgesia involves the injection of a local anesthetic agent and an opioid analgesic agent into the lumbar epidural space. These agents diffuse across the dura and act on the spinal nerve. NEURAXIAL analgesia is the most effective treatment available for pain control during labor and delivery, and it is a preferable method because it can provide more effective pain relief compared with nonneuraxial pharmacological analgesia.1 However, optimal timing of epidural analgesia (EA) has been a controversial issue and how early in the latent phase of labor can women benefit from.

Anim-Somuah M, Smyth RM, Jones L. Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev. ;(12):CD Liu EH, Sia AT. Rates of caesarean section and instrumental vaginal delivery in nulliparous women after low concentration epidural infusions or opioid analgesia: systematic review.

BMJ. Few studies have examined racial and ethnic differences in the treatment of labor pain,45,49–51 and most of these did not control for potentially important patient risk factors.

None of these studies accounted for the fact that nonwhite and white patients tend to be treated by different physicians If the use of epidural analgesia varies between physicians, then part of the observed.Background Among nulliparous women, there appears to be an association between the use of epidural analgesia during labor and an increased risk of .The authors performed an individual patient meta-analysis of 2, nulliparous women who were randomized to either epidural analgesia or intravenous opioids for pain relief during labor from five.